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Hysterectomy for the Transgender Man

  • Care for the Transgender Patient (C Unger, Section Editor)
  • Published:
Current Obstetrics and Gynecology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Our objective is to summarize the most recent, high-quality data regarding perioperative recommendations for hysterectomy and salpingo-oophorectomy in transgender and gender nonconforming individuals.

Recent Findings

Many transgender men desire hysterectomy and salpingo-oophorectomy for gender affirmation, cancer-risk reduction, pelvic pain, or abnormal uterine bleeding. Gender-confirming hysterectomy is safe, effective, and highly beneficial for well-counseled patients. Preoperative considerations include optimizing the office environment, preoperative testing specific to patients with long-term testosterone use, counseling specific to transgender men, consideration of World Professional Association for Transgender Health criteria, and coordination of a multi-disciplinary team. Minimally invasive approaches, including vaginal, laparoscopic, and robotic-assisted hysterectomy, are the standard of care for cisgender women and transgender men given lower complication rates, better post-operative outcomes, and greater cosmetic satisfaction. Concurrent appendectomy, mastectomy, vaginectomy, and urethral reconstruction may be performed at the time of hysterectomy; phalloplasty and metoidioplasty are generally performed as subsequent procedures. Same-day discharge following hysterectomy is safe and has been shown to improve post-operative outcomes. We recommend follow-up with the patient’s mental health professional and endocrinologist in addition to routine surgical follow-up. Long-term satisfaction after genital surgery appears to be high and regret is low.

Summary

More robust and up to date research is needed to improve guidelines and perioperative care for transgender individuals. Available data suggests that hysterectomy and salpingo-oophorectomy for transgender men is safe, is not associated with any additional risks compared to cisgender women, and is associated with an improved quality of life.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 4010 Old Clinic Building, Campus Box 7570, Chapel Hill, NC, 27599-7570, USA

    Michelle Louie & Janelle K. Moulder

Authors
  1. Michelle Louie
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  2. Janelle K. Moulder
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Correspondence to Michelle Louie.

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Conflict of Interest

Michelle Louie and Janelle K. Moulder declare payment from Teleflex Medical for consultancy work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Care for the Transgender Patient

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Louie, M., Moulder, J.K. Hysterectomy for the Transgender Man. Curr Obstet Gynecol Rep 6, 126–132 (2017). https://doi.org/10.1007/s13669-017-0211-5

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  • DOI: https://doi.org/10.1007/s13669-017-0211-5

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